C-Reactive Protein for the Enhanced Evaluation of the Systemic Inflammatory Response Syndrome (SIRS)

ABSTRACT

Introduction: An elevation in the CRP may provide an early indication of developing SIRS with progression to sepsis that is more sensitive than the standard clinical criteria of fever (or hypothermia), tachypnea, tachycardia, and leukocytosis with neutrophilia (or neutropenia). The problem of false positive rate for SIRS resides mainly in the common occurance of tachypnea and tachycardia in presenting patients, and in the confounding presence of neutrophilia without reference to good measures of a left shift. The objective of this study was to investigate how using CRP as a marker to confirm the presence of early sepsis might reduce the false positive rate inherent in the defining SIRS criteria.

Materials and Methods: One hundred sixty eight patients with leukocytosis greater than 12,000 associated with a high absolute neutrophil count were studied. Those that met the inclusion criteria were analyzed for CRP response.

Results: A linear correlation between CRP elevation and the defining criteria for SIRS was found except there was no correlation with absolute neutrophil count.

Conclusion: CRP is a sensitive indicator of SIRS with advantages over neutrophilia for detecting early sepsis.